Variations in awareness, treatment, and control of hypertension among different racial/ethnic groups have been widely reported. It is unclear whether these differences are explained fully by differences in socioeconomic status, insurance coverage, health status, and health behaviors, or whether these differences indicate that racial/ethnic subgroups have unique barriers to hypertension control.
Determine whether there are significant differences between racial/ethnic groups in medication use for hypertension after adjusting for potentially confounding variables.
Cross-sectional analysis of the 1992 Health and Retirement Study.
2450 non-Hispanic white, 939 non-Hispanic black, and 345 Hispanic participants, ages 51 to 61, reporting a history of hypertension.
Self-reported current antihypertensive medication use. We used logistic regression to adjust for demographics, socioeconomic status, health status, insurance, and health risk behaviors.
63.6% of white adults, 72.6% of black adults, and 52.5% of Hispanic adults reported current medication use to control hypertension (P <0.001 across all three groups). In stratified analysis, the lower rate of use for Hispanic adults was consistent regardless of gender, insurance coverage, or health status. After controlling for all variables, the adjusted prevalence for Hispanic adults was 50.8% and 73.3% for black adults.
The differences in antihypertensive medication use between white adults, black adults, and Hispanic adults, particularly the markedly lower rates among Hispanic adults, are not explained by differences in demographics, socioeconomic status, health insurance coverage, health status, or health risk behaviors. Alternative explanations for these results and areas for future research and intervention are explored.
*From the Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio.
†From the Departments of Medicine and Epidemiology-Biostatistics, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio.
Supported by grant no. R01 HS10283-01 from the Agency for Healthcare Research and Quality (AHRQ). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the AHRQ.
Address correspondence and reprint requests to: Dr. Joseph J. Sudano, Jr., MetroHealth Medical Center, 2500 MetroHealth Drive, Rammelkamp 236, Cleveland OH 44109-1998. E-mail: email@example.com
Received March 20, 2000; initial review completed May 9, 2000; accepted January 12, 2001.